多普勒超声诊断急性输尿管梗阻的实验研究

本研究利用多普勒超声对８例左侧输尿管结扎与８例正常对照家犬在术后２４小时内行双肾内动脉及肾脏超声（ＵＳ）观测，测取双肾内动脉阻力指数（ＲＩ），并与ＵＳ结果对比。结果表明，实验组梗阻侧肾ＲＩ在输尿管梗阻后８小时开始上升，且显著高于对照组肾ＲＩ（Ｐ＜０．００１），实验组双肾ＲＩ差值（＞０．１）显著高于对照组双肾ＲＩ差值（＜０．１）（Ｐ＜０．００１），在输尿管梗阻后８小时，实验组健侧肾ＲＩ显著低于对照组及术前ＲＩ（Ｐ＜０．００１），有１例家犬ＲＩ升高时ＵＳ未显示集合区扩张（１３％）。我们认为多普勒超声对诊断急性输尿管梗阻有重要意义。     

偏瘫患者健侧下肢与正常下肢的运动学比较

目的定量分析偏瘫患者健侧下肢与正常下肢的差异.方法运用Wall & Coworkers步态测试方法,采集30例偏瘫患者和30例正常人的步态影像,输入Peak运动解析系统进行分析.结果患者的健侧下肢与正常人的两下肢在时间参数、空间参数、膝关节角度等方面均存在显著差异(P＜0.01).结论偏瘫患者不仅仅患肢存在运动障碍,其"健"肢的运动与正常人相比也有显著差异,治疗时不能只针对患肢,而应全面兼顾.     

多普勒超声评价正常妊娠及妊娠并输尿管结石孕妇肾内动脉血流指数变化

多普勒超声观测Ａ组３０名健康非孕妇女、Ｂ组１４０名正常孕妇及Ｃ组１２例妊娠并输尿管结石孕妇肾内动脉血流指数（ＲＩ、ＰＩ、Ｓ／Ｄ）。结果：Ｂ组１０９名（１１８只肾）有肾积水；无论有无肾积水Ｂ组肾ＲＩ、ＰＩ、Ｓ／Ｄ值与Ａ组无显著差异（Ｐ＞０．０５），除Ｂ组４只积水肾ＲＩ＞０．７（３％）外，Ａ、Ｂ组肾ＲＩ均＜０．７，且Ａ、Ｂ组左、右侧肾ＲＩ差值均＜０．１；Ｂ组积水肾ＲＩ、ＰＩ、Ｓ／Ｄ值高低与肾积水程度及孕周无关（Ｐ＞０．０５）。Ｃ组输尿管梗阻侧肾ＲＩ、ＰＩ、Ｓ／Ｄ均显著高于Ａ、Ｂ组与对侧健肾（Ｐ＜０．００１），梗阻侧肾ＲＩ均＞０．７且与对侧健肾ＲＩ差值＞０．１。结果表明：多普勒超声观测肾动脉血流指数变化对诊断妊娠合并机械性输尿管梗阻有重要意义     

尿Tamm—Horsfall蛋白包裹游离细胞的检测方法

Tamm-Horsfall protein(TH-P)属尿中正常成份.根据Abrass 氏等报道,用自制抗人TH-P荧光抗体检测34例正常人和83例泌尿系统疾病患者尿中TH-P 包裹游离细胞(简称TH-PCFC).结果((?)+SD),正常人0.4+1.8%。下尿路疾病3.1+3.3%,且荧光强度<±.在泌尿系统疾病患者中,肾实质疾病共55例,83.6%患者尿TH-PCFC>12%:而下尿路疾病和肾、输尿管结石共28例.100%患者尿中TH-PCFC<12%,两组有显著性差异(P<0.01).从而提供一种简便无痛苦的肾实质和下尿路疾病实验鉴别诊断方法.     

彩色多普勒超声影像学与输尿管结石关系浅析

目的探讨彩色多普勒超声影像学检查在输尿管结石患者中的一些表现规律，以利于更准确地临床诊断。方法对具有输尿管结石临床表现的患者进行彩色多普勒超声影像学检查，观察肾孟积水的状态，输尿管扩张的表现，健、惠侧肾脏叶间动脉阻力指数状态的对比等多项综合因素分析诊断输尿管结石。结果肾孟积水1．5～2．0cm，结石大小为0．5～1.0cm，输尿管上开口扩张为0．5～0．7cm。肾孟积水2．0～3．0cm，结石大小为0．6～1．4cm，输尿管上开口扩张为0．5～1．1cm。肾孟积水3．0cm以上，结石大小为1．0～1．6cm，输尿管上开口扩张为1．0～1．4cm。患侧与健侧肾脏动脉阻力指数检测：两侧一致或患侧低于健侧为19．1％，而患侧高于健侧为80．9％。结论①输尿管结石患者肾积水的多少，输尿管扩张程度的高低与结石大小有一定的关系。②输尿管结石患者患侧肾脏动脉阻力指数明显高于健侧。     

双功彩色多普勒超声对原发性高血压左室肥厚肾内动脉血流？…

目的：应用双功彩色多普勒超声观察原发性高血压继发左室肥厚患者肾内动脉血流动力学的变化。方法：利用ＡＴＬＵＭ－９及ＨＰｓｏｎｏｓ－２５００超声仪检测了同一年龄组３２例正常人和３０例原发性高血压左室肥厚患者肾内动脉（段动脉，叶间动脉）的血流参数一收缩峰速度（Ｖｓｍａｘ），舒张期最低流速（Ｖｄｍｉｎ）阻力指数（ＲＩ）和加速度时间（ＡＴ）。结果：原发性高血压左室肥厚肾脏的段动脉和叶间动脉的ＲＩ，ＡＴ均较正     

健侧斜坡卧位局部按压法对减轻肾造瘘管拔管后造瘘口漏尿的效果

目的探讨健侧斜坡卧位局部按压法对减轻经皮肾镜取石术患者拔除肾造瘘管后造瘘口漏尿的效果。方法分别对2012年入住本科行经皮肾镜取石术且术后留置肾造瘘管的114例患者随机分为对照组和试验组各57例,对照组拔管后嘱患者取水平健侧卧位。试验组患者拔管后嘱患者取头高脚低45°健侧斜坡卧位,局部用手按压造瘘口敷料。观察2组患者漏尿的情况。结果试验组的漏尿时间在60min以内的患者比例为82.5%,所有患者漏尿时间均在120min以内,漏尿时间中位数60min;对照组患者漏尿大于120min的患者比例为93%,漏尿时间中位数值150min,2组比较差异有显著统计意义（P〈0.005）。结论采取健侧斜坡卧位部按压法能有效改善经皮肾镜取石术患者肾造瘘管拔管后造瘘口漏尿情况,减轻患者痛苦。     

脑卒中患者坐位及站立位胫骨前肌和腓肠肌表面肌电图信号特征研究

目的分析脑卒中患者坐位及站立位胫骨前肌和腓肠肌表面肌电图(sEMG)信号特征。方法选取15例脑卒中患者和15例正常人作为实验组和对照组,令受试者连续做5次由坐到站,采用表面电极引导和记录两侧胫骨前肌和腓肠肌肌电信号并进行线性时、频分析。结果脑卒中患者坐位患侧与健侧、健侧与正常人对应健侧胫骨前肌的平均功率频率(MPF)和中位频率(MF)差异有显著性意义(P<0.05);脑卒中患者健侧与正常人对应健侧腓肠肌均方根差异有显著性意义(P<0.05);脑卒中患者站立位患侧与健侧、健侧与正常人对应健侧胫骨前肌均方根和积分肌电(iEMG)差异有非常显著性意义(P<0.01);脑卒中患者健侧与患侧、患侧与正常人对应患侧腓肠肌均方根和iEMG差异有显著性意义(P<0.05或P<0.01)。结论sEMG是一种简单、实用、可行的康复评定方法。     

彩色多普勒血流显像对椎动脉病变的分析研究

应用彩色多普勒血流显像技术测定３０例正常人３２例椎基底动脉缺血患者椎动脉的内径、峰值血流速度、每分钟血流量、压力降半时间、阻力指数及窗口指数。结果示正常人椎动脉内径左侧占优势（Ｐ〈０．０５）。患者患侧与健侧，正常人与患者患侧相比各指标均有显著性差异（Ｐ〈０．０１或０．００１）。结论：彩色多普勒血流显像对判定颅外脑血管的病理及机能状态，特别是椎基底动脉供血情况有重要价值。     

彩色多普勒超声观测输尿管排尿评价术后肾的泌尿功能

目的：应用彩色多普勒超声通过观测输尿管排尿,评价术后肾的泌尿功能状态及恢复情况。方法：选择行手术切除的肾肿瘤患者46例,24例切除比例小于肾1/4者做为轻度损伤组,22例切除比例大于肾1/4者做为重度损伤组,以健侧做为对照组。分别于术后1～2周和7～8周行超声检查,在饮水500ml后 45～60min观测患侧与健侧输尿管膀胱开口处的尿流形态、尿流速度、排尿频率。结果：健侧彩色多普勒尿流呈鲜红色,尿流速度27～55cm/s,频率4～8次/min。患侧尿流色彩暗淡,轻度组尿流速度12～25cm/s,频率2～4次/min;重度组尿流速度0～17cm/s,频率0～3次/min,患侧组间比较及与健侧比较差异均有统计学意义。术后7～8周轻度组尿流速度19～44cm/s,频率4～7次/min;重度组尿流速度15～33cm/s,频率2～4次/min。重度组与健侧比较差异有统计学意义,轻度组与健侧比较差异无统计学意义。结论：手术所致肾损伤可引起患侧肾功能发生改变,通过观测输尿管排尿的峰值指标,可判定术后肾的泌尿功能状态及恢复情况。     

慢性肾病的彩色多普勒研究

以彩色多普勒检测３８例慢性肾病患者（７６只肾）和３２例正常对照者（６４只肾）的肾门动脉，叶段动脉，叶间动脉的最大流速和最小流速以及阻力指数，结果发现肾门动脉、叶段动脉及叶间动脉最大流速（Ｖｍａｘ），最小流速（Ｖｍｉｎ），均低于正常对照组（Ｐ＜０．００１），肾门动脉、叶段动脉和叶间动脉阻力指数高于对照组（Ｐ＜０．００５）。同时用二维测量肾脏大小，发现肾脏大小和肾内各段动脉阻力指数呈负相关，与肾内各段动脉最大流速呈正相关。     

Doppler sonography in the diagnosis of urinary tract obstruction by stone

PURPOSE: This study was conducted to evaluate the accuracy of Doppler sonography in renal colic due to obstruction and to assess whether the resistance index (RI) and interrenal RI difference (DeltaRI) are time-dependent parameters. SUBJECTS AND METHODS: Obstructed and unobstructed contralateral kidneys in 28 patients with renal colic and normal kidneys in 27 control subjects were prospectively evaluated with Doppler sonography. Mean RI, mean DeltaRI, and duration of pain were evaluated. Statistical analysis was done using paired and independent t-tests. RESULTS: Mean RIs of the control-group, obstructed, and contralateral kidneys were 0.60, 0.71, and 0.61, respectively; mean DeltaRI values of the obstructed and control-group kidneys were 0.10 and 0.03, respectively. Differences in mean RI between obstructed and contralateral or control-group kidneys were statistically significant (p < 0.001). There was a statistically significant difference in DeltaRI between patients and controls (p < 0.001). The difference between the RI values of kidneys with low-grade (0.70) and high-grade obstructions (0.72) was not statistically significant. The difference between the DeltaRI values of kidneys with low-grade (0.08) and high-grade obstructions (0.13) was statistically significant (p < 0.05). Differences in the mean RI and mean DeltaRI values between 3 groups of patients categorized according to the duration of pain were not statistically significant. CONCLUSIONS: Along with gray-scale sonography and intravenous urography, Doppler sonography can be used in the evaluation of renal obstruction. RI and DeltaRI are not time-dependent parameters.     

小儿肾积水血流动力学观察及临床意义

目的:研究小儿肾积水血流动力学指标及其临床意义。方法:应用彩色多普勒超声对20例正常小儿肾脏及30例小儿积水肾进行血流动力学研究。结果:①正常小儿肾脏主肾动脉(MRA)、段动脉(SRA)、叶间动脉(IRA)的血流收缩期峰值速度(PS)、舒张期峰值速度(ED)、平均速度(TAMx)、最低速度(TAMn)依次逐渐减小(P<0.01),MRA、SRA、IRA的阻力指数(RI)无明显改变(P>0.05);积水肾的PS、ED、TAMx、TAMn比正常肾脏的血流速度低(P<0.01),积水肾RI比正常肾RI大(P<0.05)。②肾积水术后1个月RI改善最明显,以后的改善将减缓,而其余各项指标在1~6个月期间恢复最为明显。结论:①肾积水时其血流动力学发生相应的变化,其中RI的变化具有较大临床意义。②梗阻性小儿肾积水,其SRA段RI>0.66。③术后RI值不降或反而升高,提示梗阻未完全解除,需再次手术治疗。     

Compensatory renal growth in children and adults studied by Doppler sonography

To identify modifications of kidney morphology and of the time-velocity spectral waveform associated with long-term compensatory hypertrophy, spectral Doppler sonography was performed in 30 children and adults with solitary kidneys 7 years to 28 years following nephrectomy. Doppler signals were obtained from three arterial sites in each kidney. The average renal volume was 207 mL and the mean hypertrophy of the kidneys was 186%. The mean value of pulsatility (PI) and Pourcelot (RI) indexes of solitary hypertrophied kidneys was significantly lower than that of normal paired kidneys or allografts with normal function described in the literature. The PI and RI were found to correlate inversely with the kidney volume and the body surface area (BSA). In spite of a long follow-up time, no patient suffered from renal failure. This study suggests that in the case of solitary kidney, specific ranges of PI and RI should be employed rather than those used with paired kidneys. © 1994 John Wiley & Sons, Inc.     

经阴道彩色多普勒超声对不孕症患者卵巢动脉的研究

通过对３６例原发性不孕症患者和４２例正常妇女卵巢动脉的研究，发现正常妇女卵巢动脉血流参数ＲＩ在卵泡期高于黄体期，二者比较有显著性差异（Ｐ值＜０．０５）。不孕症患者与正常组比较，前者的卵巢动脉峰值流速高于后者，二者比较有显著性差异（Ｐ值＜０．０５）。ＲＩ有极其显著性差异（Ｐ值＜０．０１）。研究结果提示：原发性不孕症患者卵巢动脉供血存在异常     

Doppler evaluation of pediatric goiter: effect of mandatory iodination

PURPOSE: The aim of this study was to evaluate the hemodynamic status of the thyroid in children with goiter after the use of iodinated dietary salt for 3 years in a region of endemic iodine deficiency. METHODS: Sixty-six children between 7 and 12 years of age were included in the study. Three groups were constituted according to sonographically measured thyroid volume and urinary iodine excretion levels. Group 1 included 11 children with thyroid volumes greater than the 97th percentile according to age and sex criteria suggested by the World Health Organization International Council for Control of Iodine Deficiency Disorders and urinary iodine level lower than 100 microg/l. Group 2 included 30 children with thyroid volumes greater than the 97th percentile and urinary iodine level equal to or higher than 100 microg/l. The control group included 25 children who had normal thyroid volume and urinary iodine level. All children were examined by thyroid duplex sonography. Peak systolic velocity (PSV) and resistance index (RI) were measured in the inferior thyroid artery bilaterally. RESULTS: PSV in group 1 was significantly higher than in group 2 and in the control group (P < 0.05 and P < 0.01, respectively). There was no significant difference between the PSV of group 2 and the control group. The RI in groups 1 and 2 was significantly lower than in the control group (P < 0.01 and P < 0.01, respectively). There was no significant difference between the RIs of group 1 and group 2. CONCLUSIONS: These findings suggest an effect of iodination on thyroid hemodynamics before the size of the hyperplastic thyroid returned to normal, in keeping with normalization of the urinary iodine level.     

彩色多普勒血流显像对Ⅱ型糖尿病患者肾内动脉血流的研究

应用彩色多普勒血流显像（ＣＤＦＩ）检查５９例Ⅱ型糖尿病（ＤＭ－Ⅱ）患者的肾内动脉血流动力学参数，并以４０名正常人为对照。结果提示：ＲＩ是反映肾内动脉血流阻力大小的客观指标之一。ＤＭ－Ⅱ组肾功能在正常范围者，已有部分病例ＲＩ增高，表明肾内动脉血流阻力异常较肾功能异常出现为早。     

急性和慢性肾功能衰竭急性发作的彩色多普勒诊断

目的：应用CDFI诊断急性肾功能衰竭和慢性肾功能衰竭急性发作。方法：应用CDFI对ARF和CRF急性发作患者及一组正常人进行肾大小,肾皮质厚度及肾血流动力学测定。结果：（1）ARF肾脏体积明显增大,CRF急性发作肾脏体积明显缩小,二者与正常对照组比差异显著（P＜0．01）。（2）ARF肾皮质增厚,CRF急性发作肾皮质菲薄或完全显示不清,与正常组相比差异显著（P＜0．05）。（3）ARF肾Vmax与正常组相比差异不明显,CRF急性发作RI值与正常组差异不明显,但ARF与CRF急性发作两组相比差异显著（P＜0．01）。结论：CDFI可及时诊断病因,判断病情,了解肾内血流情况,为ARF和CRF急性发作的诊断及治疗,判断愈合开辟了新的途径。